The URL can be used to link to this page

Home My WebLink AboutBLDE-21-006215 Commonwealth of Official Use Only Permit No. BLDE-21-006215 Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:4/27/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 4 CHURCH ST Owner or Tenant JOHNSON WILLIAM F TRS Telephone No. Owner's Address JOHNSON ANNE T TRS,4 CHURCH ST,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement boiler. Completion of the following table may be waived by the Inspector of.Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ANDREW G THOMAS Licensee: ANDREW G THOMAS Signature LIC.NO.: 22152 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:7 ECHO LN,CHATHAM MA 02633 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 . \ Conentonamanh al Maasachum& Official Use Only Permit No. `. ...."--2.--(— (272 C .2isparinsaal a I..7im—corviesi Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] ,,......v (leave blank) ‘.3 ,..) APPLICATION FOR PERMIT TO PERFOR ELECTRICAL ORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMA770N) Date: /41:11 Ao a b.11 I City or Town of: y,tith ov.iii To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. 0 Location(Street&Number) 4 0,1/4,(L-11 Si(ciI .,..) 3 Owner or Tenant HIE...1'k, "1-0k,i7kon Telephone No. -,-- -1-' Owner's Address f-k 3 Is this permit in conjunction with a building permit? Yes 0 No El (Check Appropriate Box) L: ' 1% .1 t,‘ 13 , Purpose of Building {i-sx ,. , Utility Authorization No. ..) ' V Existing Service 1)-4)() Amps \10 / Illib Volts Overhead El Undgrd 2 No.of Meters ,!...11 '. New Service Amps / Volts Overhead E Undgrd E No.of Meters c o Number of Feeders and Ampacity r Location and Nature of Proposed Electrical Work: tx,<1(4.---, i7o,kt( 1.,..,.(o) t,„,',L, Ion c (11441,,Is *clam-a c,,;_vv.,70f I Completion of the following table may be waived by the bispector of Wires, No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA '.- No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ri In- 1---1 No.of Emergency Lighting grnd. L-I grnd. 1--1 Battery Units . , No.of Receptacle Outlets '), No.of Oil Burners FIRE ALARMS No.of Zones o N .of Detection ind No,of Switches 1. No.of Gas Burners Initiating Devices .... . Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 'HeatPump Number'Tons KW 4No.of Self-Contained No.of Waste Disposers Totals: _ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW ,Local 0 Neleunnuideeptial 0 other — . No.of Dryers Heating Appliances KVV Security Systems:1 No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters \ KW Sips Ballasts No.of Devices or Vuivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications inng: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 1200-4,0 (When required by municipal policy.) Work to Start: Li iolvial I Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no petillit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Vi BOND 0 OTHER 0 (Specify:) I certifr,under the pains and penalties of perjury,that the information on this application is true and complete. -FIRM NAME: ltiop,4 Elalsol 5-tc\AL4 Inc- LIC.NO.: Licensee: AvVVt,-/ NA4- Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: tel 7-615--3711 Address: 2 al,, Alt.Tel No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent.. Owner/Agent Signature Telephone No. PE . IT FEE: $